As I advance in age, I am exposed more and more to the health care industry, despite having enjoyed relatively good health until recently. As a retired New York State employee, I am blessed with excellent health insurance that covers most doctor visits, medical tests and procedures, as well as prescription drugs, with only a relatively modest co-pay. Here are a few observations:

First, it appears that many of our health problems are what a friend of mine calls “diseases of affluence.” More appropriately, they should be called “diseases of lifestyle,” since they affect people of all socioeconomic strata. A lot of these are directly influenced by government policies. For instance, our auto-centric physical infrastructure minimizes the opportunities for and pleasures of walking and cycling, and cannot help but contribute to obesity and other problems based on lack of physical activity. Our government subsidies to cane sugar and corn (the main ingredient of high fructose corn syrup) help make junk food and sugared soft drinks attractively priced. This is especially so for the poor, since the SNAP program (formerly known as Food Stamps) allows their purchase with SNAP benefits. If we collectively spent more on complete streets that were friendly to pedestrians and cyclists, as well as cars, how much could we save on health care (not to mention on school transportation)? How about if we stopped subsidizing sugar? I think it would be worth a try.

For all the criticism leveled against it, the Affordable Care Act (“Obamacare”) has achieved something great — it has shifted the dialog from whether health care insurance should be extended to many of those who don’t have it to how the present system should be replaced or improved. Neither Trump nor his minions are suggesting that those who obtained health insurance through Obamacare should lose it, meaning that they recognize that there is no going back on government’s commitment to growing numbers of its citizens. Whether things actually get better or worse remains to be seen, but at least no one is talking a bout a pre-Obamacare “reset.” To me, that is yuge.

A few weeks ago, I made an appointment with a doctor’s office. I was told it was for 9:15 on a given morning, and that’s what I entered in my calendar. Today, the office called to confirm the appointment, and the secretary added: “We want you to be there twenty minutes before.” My response: “then why didn’t you tell me that when I made the appointment?” The response was that the 20 minutes would be for me to fill out paperwork, which they only ask of first-time patients. Again, I asked, “why wasn’t I told that when I made the appointment?” The light bulb finally went on in the receptionist’s head, and she admitted I had a point.

Not long ago, something similar happened to me when I had an appointment with another arm of the same octopus (Community Care Physicians). When I showed up at the appointed time, I was asked if I just had come from having a sonogram. I replied that that was the first time I had heard about a sonogram, and that if I was supposed to have come early for that purpose, I should have been told. I received an apology, and the ultrasound technician squeezed me in.

Both these scenarios indicate that what I thought were appointments for me were actually appointments for the doctors who were seeing me. While they were given the correct information about when I would be available for them, I was not given the correct information about what else was expected of me. I understand and respect the value of doctors’ time, but Community Care also should understand and respect the value of its patients’ time, and let them know when to show up for what will be required of them, not just when the doctor herself or himself will be seeing them.